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ATC codes: J01GA01
EMLc
Indication
Multi-drug resistant tuberculous Mycobacterium ICD11 code: ML32.00
INN
Streptomycin
Medicine type
Chemical agent
Antibiotic groups
List type
Complementary
Formulations
Parenteral > General injections > IV: 1 g powder for injection (as sulfate) as vial
EML status history
First added in 1977 (TRS 615)
Changed in 1979 (TRS 641)
Changed in 2007 (TRS 950)
Changed in 2009 (TRS 958)
Changed in 2013 (TRS 985)
Changed in 2017 (TRS 1006)
Sex
All
Age
Also recommended for children
Therapeutic equivalence
The recommendation is for this specific medicine
Patent information
Patents have expired in most jurisdictions
Expert Committee recommendation
The Expert Committee recommended the deletion of streptomycin powder for injection from the core list of the EML as a first-line antituberculosis treatment option, noting the advice from the WHO TB department that it is no longer recommended as first-line treatment. The Committee noted that streptomycin remains in the Complementary List of the EML and EMLc for second-line use in multidrug-resistant (MDR-TB) tuberculosis.
Background
Streptomycin is currently included in the core list of the EML under Section 6.2.4 for first-line treatment of tuberculosis. It is also included in the Complementary List of the EML and EMLc as a reserve second-line drug for MDR-TB.
Public health relevance
Not provided
Benefits
In February 2017, the WHO Guidelines Review Committee approved the new WHO Guidelines for the treatment of drug-susceptible tuberculosis and patient care, 2017 update (in press at that time). The updated guidelines no longer recommend the use of streptomycin as a component of first-line antituberculosis therapy but reserve its use as a potential option in second-line regimens for drug-resistant disease.
Harms
Not provided
Additional evidence
N/A
Cost / cost effectiveness
N/A
WHO guidelines
Refer to the summary for deletion of ofloxacin for recommendations regarding the use of streptomycin in MDR-TB and rifampicin-resistant (RR-TB) disease in current WHO guidelines.
Availability
N/A
Other considerations
The current listing of streptomycin on the Complementary List of the EML and EMLc as a reserve second-line drug for treatment of MDR-TB will be retained.
Implementation considerations
N/A